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Diagnostic Procedures in Women With Locally Advanced Breast Cancer Who Are Receiving Chemotherapy Before Breast Cancer Surgery

Information source: Alliance for Clinical Trials in Oncology
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Breast Cancer

Intervention: biopsy (Procedure); magnetic resonance imaging (Procedure); radiomammography (Procedure); ultrasound imaging (Procedure); gadopentetate dimeglumine (Radiation); chemotherapy (Drug)

Phase: N/A

Status: Active, not recruiting

Sponsored by: Alliance for Clinical Trials in Oncology

Official(s) and/or principal investigator(s):
Laura J. Esserman, MD, MBA, Study Chair, Affiliation: University of California, San Francisco

Summary

RATIONALE: Comparing results of diagnostic procedures performed before, during, and after chemotherapy may help doctors predict a patient's response to treatment and help plan the most effective treatment. PURPOSE: Diagnostic trial to study magnetic resonance imaging (MRI) and biomarkers in women who are receiving chemotherapy before surgery for locally advanced breast cancer.

Clinical Details

Official title: Contrast-Enhanced Breast MRI, MRS, And Correlative Science Studies To Characterize Tumor Response In Patients Undergoing Neoadjuvant Treatment For Locally Advanced Breast Cancer

Study design: Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic

Primary outcome: response

Detailed description: OBJECTIVES: Primary

- Support accrual to the ACRIN-6657/CALGB-150012 magnetic resonance imaging (MRI)

correlative science study.

- Determine whether molecular markers, alone or in combination with MRI, at the time of

diagnosis or early in the course of therapy, predict 3-year disease-free survival (DFS) in women with locally advanced breast cancer who are receiving neoadjuvant chemotherapy.

- Identify two groups of participants who have statistically different 3-year DFS, based

on 1 or more biomarkers, including MRI.

- Determine whether biomarkers, in combination with MRI, early in the course of

chemotherapy, improve the prediction of 3-year DFS and are at least as good of a predictor of DFS as residual disease at the time of surgery in these patients.

- Determine whether molecular markers are associated with specific imaging patterns seen

on MRI of these patients.

- Predict response with MRI results and marker data from cell cycle check points,

proliferation, angiogenesis, hormone receptors, and molecular profiles in these patients. Secondary

- Determine the molecular predictors of lack of radiologic complete response (CR) in

HER-2/neu negative patients (immunohistochemistry [IHC] score of 0, 1+, 2 and fluorescence in situ hybridization [FISH] not amplified) after a neoadjuvant anthracycline-based regimen.

- Determine the molecular predictors of lack of radiologic CR in HER-2/neu positive

patients (IHC 3+ or FISH amplified > 2. 0) after a neoadjuvant anthracycline-based regime followed by a taxane alone regimen or in combination with trastuzumab.

- Determine the molecular predictors of complete magnetic resonance imaging radiologic

response to a neoadjuvant anthracycline-based regimen when gene expression profiling is performed in a sequential, real-time fashion. OUTLINE: This is a diagnostic, multicenter study conducted concurrently with CALGB-150012/ACRIN-6657 imaging protocol and concurrently with neoadjuvant anthracycline-based chemotherapy. Patients receive an injection of gadopentetate dimeglumine and undergo magnetic resonance imaging (MRI) of the breast before initiation, 1-3 days after initiation, and then after completion of neoadjuvant anthracycline-based chemotherapy and prior to surgery. Patients who previously received a taxane also undergo an additional contrast-enhanced MRI scan. Patients undergo biopsies before initiation and at the time of surgery. Patients also undergo blood draws at the time of the first biopsy and prior to surgery. Serum and tissue samples are used to assess biomarkers of genetic instability, cell cycle progression and cellular proliferation as predictors for anthracycline responsiveness, markers of apoptotic potential as predictors for taxane responsiveness in vivo, angiogenesis, hormone receptors, and molecular profiles using immunohistochemical methods. Mammograms and possibly ultrasounds are performed prior to and after chemotherapy (before surgery). Patients are followed every 6 months for 5 years and then annually for up to 10 years. PROJECTED ACCRUAL: A total of 384 patients will be accrued for this study within 3 years.

Eligibility

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Female.

Criteria:

DISEASE CHARACTERISTICS:

- Histologically confirmed newly diagnosed adenocarcinoma of the breast by core needle

biopsy, incisional biopsy, or fine needle aspiration (FNA)

- Incisional biopsy must result in < 10% removal of gross residual disease

- Measurable disease

- At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques

OR ≥ 10 mm by spiral CT scan OR

- Nonmeasurable disease

- Meets one of the following staging criteria:

- Stage II or III disease

- T4, any N, M0, including clinical or pathologic inflammatory disease

- Regional stage IV disease where supraclavicular/infraclavicular lymph nodes are

only site of metastasis

- No clinical or imaging evidence of distant metastasis

- Metaplastic carcinomas allowed

- Synchronous bilateral primaries allowed if the more advanced tumor meets staging

criteria

- Patients for whom FNA was used to confirm initial diagnosis must have histologically

confirmed invasive carcinoma by the start of chemotherapy

- Her-2/neu status known

- Currently receiving neoadjuvant chemotherapy consisting of a taxane-based regimen

alone or followed by an anthracycline-based regimen

- Concurrent enrollment in the ACRIN-6657/CALGB-150012 imaging protocol required

- Hormone receptor status:

- Any estrogen receptor or progesterone receptor status

PATIENT CHARACTERISTICS: Age

- 18 and over

Sex

- Female Cardiovascular

- No uncontrolled or severe cardiovascular disease

Other

- Not pregnant or nursing

- Negative pregnancy test

- No ferromagnetic prostheses including the following:

- Metallic implants not compatible with a magnetic resonance imaging machine

- Heart valves

- Aneurysm clips

- Orthopedic prosthesis

- Any metallic fragments anywhere in the body

PRIOR CONCURRENT THERAPY: Chemotherapy

- See Disease Characteristics

- No prior chemotherapy to the ipsilateral breast for this malignancy

Endocrine therapy

- At least 4 weeks since prior tamoxifen or raloxifene

Radiotherapy

- No prior radiotherapy to the ipsilateral breast for this malignancy

Other

- No other prior cytotoxic regimens

Locations and Contacts

UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California 94115, United States

University of Chicago Cancer Research Center, Chicago, Illinois 60637-1470, United States

Masonic Cancer Center at University of Minnesota, Minneapolis, Minnesota 55455, United States

Memorial Sloan-Kettering Cancer Center, New York, New York 10065, United States

Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill, Chapel Hill, North Carolina 27599-7295, United States

Additional Information

Clinical trial summary from the National Cancer Institute's PDQ® database

Related publications:

Carey LA, Oh D, Sawyer L, et al.: Gene expression subtype and p53 mutational status are correlated among neoadjuvantly treated breast cancers in UNC LCCC9819 and I-SPY1 (CALGB 150007/ACRIN 6657). [Abstract] J Clin Oncol 24 (Suppl 18): A-10048, 552s, 2006.

Starting date: February 2002
Last updated: July 23, 2015

Page last updated: August 23, 2015

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